The state Department of Health and Human Resources must develop a comprehensive plan to address the staffing shortages and patient needs at the state’s two psychiatric hospitals by June 11, according to a court order issued Tuesday.
William R. Sharpe Jr. Hospital, in Weston, and Mildred Mitchell-Bateman Hospital, in Huntington, have been the focus of an ongoing court case centered on the appropriate treatment of mental-health patients remanded to state care.
Kanawha County Circuit Court Judge Louis “Duke” Bloom ordered the DHHR to develop a plan to address noncompetitive wages, mandatory overtime and other issues at both facilities that have caused a number of employee vacancies.
“I want the department to prepare and be prepared to present to the court their plan to correct these problems, and they should consult with the Governor’s Office, the Division of Personnel, and have an action plan ready for immediate implementation,” Bloom said.
“Don’t come back and tell me that’s it’s subject to legislative approval. … I want to know what your plan is. Failure to do so, and the court may very well have to develop its own plan.”
In 1982, the West Virginia Supreme Court ruled in E.H. v. Matin (the “Hartley case”) that it was against state mental-health law to “warehouse” a patient in a mental-health facility.
Both hospitals were court monitored for 20 years, until another Kanawha County Circuit Court judge lifted that monitoring in 2001 and ordered an ombudsman to keep track of both facilities. The case was reopened in 2009, after it was determined that conditions had deteriorated at both hospitals.
Sharpe Hospital, a 150-bed facility that would normally employ 456 staff, had 48 vacancies as of March 30. Bateman Hospital, which should have a staff of 393, had 41 vacancies as of March 30.
Victoria Jones, commissioner for the West Virginia Bureau for Behavioral Health and Health Facilities, a division of the DHHR, testified Tuesday that the hospitals are kept adequately staffed by contractual employees and mandatory overtime.
Sharpe and Bateman recorded 4,162 hours of overtime among employees in March. In that same time frame, employees requested 2,876 hours of unscheduled leave — a disparity Jones attributes to other needs that require additional overtime for both facilities.
“We have a number of individuals on accommodation, which means they have various reasons they’ve unable to work, or unable to work for more than eight hours a day,” Jones said. “We have changes in our acuity that unexpectedly require us to maintain additional levels of employment on our units, and we have scheduled leave hours that are not counted within unscheduled leave hours.”
The state also hires new employees at well below competitive starting salaries for private facilities and does not provide enough raises and incentives to retain existing employees, according to Jennifer Wagner, managing attorney for Mountain State Justice, the nonprofit firm representing the patients of both hospitals in the Hartley case.
According to Wagner, the DHHR’s practice of hiring contractual employees to fill the vacancies at both hospitals is significantly more expensive than filling those positions with full-time employees.
Marlon Taylor, director of employee relations and compensation at Cabell Huntington Hospital, testified that its registered nurses earned an average of $63,773 per year, its licensed practical nurses earned an average of $44,429, and its nursing assistants earned $34,174 per year.
In comparison, the average salary for direct care and health service workers, including nursing staff, at Bateman is $22,152 per year and the average salary at Sharpe is $22,644. The cost to pay contractual employees, all of whom are hired out-of-state, is an average of $39 per hour. Wagner said she has calculated that the cost of retaining a similar health service employee full time at the current rate is between $12 and $20.
The raises employees of both hospitals have received since 2009 have come from across-the-board state employee raises or from court-mandated raises arising from the case. In a 2009 court order, the DHHR was required to implement raises in certain classifications, and eliminated a 3 percent retention incentive in order to comply, Jones said. The order did not mention the retention incentive, but Jones said its elimination was necessary to stay within the agency’s “limited budget.”
Both hospitals also are missing critical-care staff that put them in violation of state code. Bateman has not had a recreation specialist who would be responsible for coordinating community integration programs for two years, and Sharpe does not have a forensic coordinator for its forensic patient population. Forensic patients are those who remanded by a judge to a psychiatric facility if they are deemed unfit to stand trial.
The next hearing of the case will take place June 11 at 1:30 p.m. on the fifth floor of the Kanawha County Judicial Building.
Reach Lydia Nuzum at firstname.lastname@example.org or 304-348-5189.
“Total costs, including benefits, of a health services contract employees are significantly higher than the cost for a health services worker that is a full-time employee of the department,” Wagner said.